Pulmonary Hypertension As A Risk Factor In Mitral Valve Replacement

The study included 30 patients with mitral valve disease andpulmonary hypertension. The age of these patients ranged between 16 to 52years (mean 31.4 ± 11.3 years), 18 females and 12 males. They underwentmitral valve replacement. These patients were classified into:-Group (A) : Mild pulmonary hypertension (30 to 45 mmHg).Group (B) : Moderate pulmonary hypertension (45 – 60 mmHg ).Group (C) : severe pulmonary hypertension (more than 60 mm Hg).Nine patients (30%) had mitral regurgitation, 12 patients (40%) hadmitral stenosis and 9 patients (30%) had combined lesions. By the NewYork Heart Association criteria, 6 patients were in class 1, 12 patients werein class 11, 8 patients in class III and 4 patients in class 1V.The means of jugular vein distention were 8.9 ± 0.7 cm in group A,10.2 ± 0.8 cm in group B and 11 ± 0.8 cm in group c .The means of hepatomegally were 1.95 0.8 fingers in group B and2.9 ± 0.6 fingers in group C. Ten patients had mild oedema, 14 patients hadmoderate oedema, 2 patients had severe oedema and 4 patients had nooedema. Sixteen patients were AF, and fourteen patients were sinus. Sixpatients had mild T. R., 12 had moderate T. R., 4 patients had severe T. R.and 8 patients showed no tricuspid valve lesion . The means of left atrialsize were 49.7 ± 7 mm in group A , 66.6 ± 6 mm in group B and 80.5± 7mm in group C.114SainilOw/di/slimThe means of R.V.E.D. were 17.3 ± 4 mm in group A, 23.2 ± 4 mmin group B and 29.4 ± 3 mm in group C.The means of P.A.SP. were 38 ± 3.5 mm Hg in group A , 53 ± 4 mmHg in group B and 79.8 ± 5.6 mm Hg in group C.All patients showed signs of pulmonary congestion and pulmonaryhypertension. The means C. T. ratio were 0.4 ± 0.06 (A), 0.51± 0.07 (B)and 0.61 ± 0.06 (C).